Some people look 10 years older than their stated age, and we often wonder: what causes premature aging? Accelerated or premature aging can have a multitude of underlying causes. I will list a few here:

1. Weakening hormones

Men go through andropause at around the age of 60 to 65 and women go through menopause around the age of 55 to 65. In both males and females it is the sex hormones that are missing around that age. If hormones replacement follows fairly quickly with bioidentical hormones, this will not affect the visual appearance that much. In contrast, if bioidentical hormones are not the therapeutic choice for hormone replacement, but synthetic ones, the hormones are not in balance, as synthetic hormones do not restore the hormonal balance. Nothing is gained, as the person will still age prematurely.

Synthetic versus bioidentical hormone replacement

In addition the synthetic hormones will cause heart attacks, strokes, clots, and cancer. Prescriptions for synthetic hormones are often the cause that the aging patient population gets these serious complications. Frequently physicians insist on using synthetic hormones from a “reputable” drug company to replace missing hormones. The reason this does not work is that a male has testosterone receptors. They need to be stimulated by bioidentical testosterone to restore all of his missing functions. Also, the same is true in menopausal females who need stimulation of their estrogen receptors and progesterone receptors. Consequently, only bioidentical hormones will return a postmenopausal woman back to normal. There is a perfect fit between the bioidentical replacement hormones and her hormone receptors. Using synthetic hormones is like trying to unlock a door with a key that does not have a perfect fit: you damage the lock!

2. Missing human growth hormone (HGH) and thyroid hormones

These hormones have a special place in aging.

Human growth hormone deficiency

First, HGH production is running out in many people at age 60. A person with HGH deficiency will have lower muscle mass and strength. Other symptoms are dry and thin skin, particularly at the back of the hands. Men are balding, and they loose interest in sex. There are difficulties concentrating and they may have “senior moments”, which are memory lapses. Often they are prone to depression and anxiety. A blood test will frequently show elevated triglycerides. A blood test (IGF-1) and a urine test exist which make it possible to look for HGH metabolites to assess whether a 40, 50 or 60 year-old person is producing enough HGH. Many may need replacement of HGH. This is administered by injection through a tiny needle into the skin, similar to a diabetic injecting insulin. This will bring back what was missing due to HGH deficiency.

Thyroid hormone deficiency

Thyroid hormones (T3 and T4) are other important factors that could make you look older prematurely. Your hair is getting thinner; your skin turns dry and pale. The nails may be getting brittle. When the outside half of the eyebrows is very thin or missing, this can be a sign of hypothyroidism. In a similar vein the skin in the face may be puffed up due to swelling of the layers under the skin (myxedema). It is important to diagnose hypothyroidism, which is common in the aging population. The physician needs to order a blood tests (TSH, T3 and T4). If TSH is above the upper limit, your physician needs to replace both T3 and T4 by tablets (I prefer Armour as the T3 and T4 is balanced).

3. Smoking

The lining of the airways absorb cigarette smoke. The chemicals circulate around in the blood and lead to aging of the skin. Chronic cigarette smoke exposure also melts away the subcutaneous tissue. The end result is a haggard look. The natural glow disappears from the skin and because of carbon monoxide binding to hemoglobin the skin color looks more greyish. In addition the blood vessels are narrowing or clogging. This means that the body cannot absorb nutrients as well, and cells are starving. There is only one remedy for this: quit smoking!

4. Overexposure to ultraviolet light

The radiation of UV light can penetrate deep into and under the skin. This makes the subcutaneous fat melt away. The largest UV exposure is in the facial area. As a result we see aging there. The end result is a sagging appearance of the face. This link has an image of a woman before and after a non-surgical facelift with stem cells and fatty tissue: Stem Cell Treatments That Are Currently Available – Medical Articles by Dr. Ray

In a surgical procedure the physician harvests mesenchymal stem cells from fatty tissue by liposuction. A cell separator separates the mesenchymal stem cells, the connective tissue and the fat cells. The connective tissue is discarded. Mesenchymal stem cells and fat cells are mixed and injected into the thinned subcutaneous fatty tissue until the person’s younger facial contour is back to normal. Typically this will last for 10 years or more.

5. Drugs and alcohol abuse

Both can lead to malnutrition with weight loss and loss of subcutaneous fatty tissue, which causes sagging breasts in women. In men “beer tits” are common. The reason for this is estrogen accumulation, as alcohol interferes with the elimination of estrogen in the liver. Alcohol is a general cell poison. It causes all of the cells to age prematurely. The more alcohol you drink, the faster you age. The skin develops wrinkles, loss of elasticity and collagen, redness and puffiness. In other words chronic alcohol abuse ages you prematurely. The only remedy for this is to quit drinking. Some of your skin vitality may come back. Our body has an amazing capability to heal itself!

6. Medical illnesses

Many medical illnesses like diabetes, mental illness (depression and schizophrenia), multiple sclerosis, inflammatory bowel disease; cancer and others make you look a lot older very fast.

I will briefly explain the reasons for this.

Diabetes

With diabetes type 2 the pancreas releases too much insulin after a meal with starches and sugar; think about a sweet muffin or a toast with jam. The extra insulin causes inflammation. This stimulates enzymes that break down elastin and collagen, leading to wrinkles and sagging skin.

Mental illness like depression and schizophrenia

We know from studies that depression leads to shortening of telomeres. This in turn causes cell death in the most rapidly dividing cells like in the skin and hair follicles. The end result is prematurely aged hair and skin. Schizophrenia also leads to premature shortening of the telomeres, which causes premature aging, mitochondrial dysfunction, inflammation and oxidative stress. The end result is that the person looks older than what their chronological age is.

Multiple sclerosis

It is sometimes difficult to discern in patients with MS what is normal aging and what is aging from the disease. This link gives some background on this. Many MS patients are anxious, and anxiety and stress by itself also leads to premature aging.

Inflammatory bowel disease

The chronic inflammation of either ulcerative colitis or Crohn’s disease can lead to premature aging. High doses of vitamin D3 and molecularly distilled fish oil can be useful to help treat the inflammation. Probiotics are also important to restore the bowel flora.

Cancer

Cancer leads to cachexia (excessive weight loss). There is also excessive inflammation, which leads to accelerated aging. The inflammation causes increased oxidative stress. This leads to tissue damage and DNA damage, which makes all cells more vulnerable to develop other cancers. Oxidative stress can substantially accelerate telomere shortening. As a result skin can become saggy, wrinkles develop and the person looks prematurely aged.

7. A chronic lack of physical activity

People who never exercise tend to get overweight and eventually obese. This leads to premature aging. Exercise would elongate telomeres, but inactivity shortens them. Obesity leads to increased oxidative stress and to DNA damage. Obesity also shortens telomeres. All of this leads to premature aging.

What Causes Premature Aging?

Conclusion

These are only a few examples of causes of accelerated aging. The key is to stick to a healthy, balanced diet (like the Mediterranean diet) and exercise regularly. Stop smoking (if you do), don’t take street drugs, and make sure you get enough sleep. Getting enough sleep helps your hormones regenerate overnight. The sympathetic overdrive from your daily activities is counterbalanced by the parasympathetic activities during sleep that causes relaxation. For hormone replacement you may have to see an anti-aging physician, a naturopath or integrative medicine physician. This may be your only chance to address any hormonal deficiencies. Conventional medicine does a very poor job of HRT (hormone replacement therapy) with synthetic hormones. Conventional practitioners want to treat you with synthetic hormones that will make you sick. Hormones for replacement have to be bioidentical! This way you will live 10 to 15 years longer, look younger and stay healthy.

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When your cholesterol is high, what can you do to lower cholesterol? First, there is the bad cholesterol, called LDL cholesterol that should not be too high. Furthermore, there is the good cholesterol, called HDL cholesterol that you want to be to higher to protect you from hardening of the arteries. LDL cholesterol finds its way into plaques of arteries, and later calcification occurs. HDL cholesterol does the opposite; it dissolves LDL cholesterol and brings it to the liver.

Food contributes only to a small portion to the increases of your LDL cholesterol (the bad cholesterol) in the blood. The minor part of the body’s cholesterol stems directly the refined carbs and trans fats from your diet. Here are a number of steps that will protect your heart from LDL cholesterol.

2. Eliminate trans fats

We need to eliminate trans fats as they are causing heart attacks. There is an important difference between ruminant trans fats and artificial trans fats. Ruminant trans fats have been part of the human diet for millennia like milk fat and fat from cows that are on pasture and lamb. Milk products for instance contain fat with 2-5% natural trans fats. 3-9 % of the fat in beef and lamb consists of natural trans fats. Studies have shown that the body is able to handle these natural trans fats and heart attacks are not more frequent in people eating moderate amounts of these products including butter from cows that graze on pasture.

Artificial trans fats

Quite the opposite is true for artificial trans fats in margarine that comes from vegetable oil. Avoid bakery items like sweet pieces or muffins and other products that contain hydrogenated oils. Read labels! Use olive oil or coconut oil, but avoid vegetable oils like corn oil, safflower oil or grape seed oil to get away from trans fats and unstable oils that turn rancid. Rancid oils contain free radicals that oxidize LDL cholesterol and attack the lining of your arteries.

3. Cut out sugar and starchy foods

You need to cut out sugar and starchy foods because these will raise your LDL cholesterol and triglycerides, which also leads to hardening of your arteries. This is an important observation. Starchy foods are broken down by pancreatic juices into sugar, which enters your blood stream, causing an outpouring of insulin from the pancreas. When the short-term storage of sugar as glycogen is exhausted in muscle and liver tissue, the liver has to process any surplus of sugar that is still there. The end results are triglycerides and LDL cholesterol. Unfortunately the protective HDL cholesterol does not reach higher levels, when the LDL cholesterol is increased. A persistent diet of high-refined carbs will increase the risk for heart attacks and strokes. It follows from this that we are all better off cutting out sugar and starchy foods from our food intake.

4. Increase your soluble fiber intake

Increase your soluble fiber intake by eating vegetables, oats and oat bran, lentils, fruits and beans. Why does this decrease LDL cholesterol? The liver tries to eliminate too much cholesterol by binding it to bile salts and excreting it into your small bowel. But the last part of the small bowel reabsorbs some of these bile salts , and from there they return to the liver. This is called the enterohepatic pathway of bile salts. Soluble fiber intake binds those bile salts and prevents re-absorption in the enterohepatic pathway, eliminating cholesterol safely in stool. Soluble fiber from psyllium, pectin, beta-glucans and others have been shown in clinical trials to reduce LDL cholesterol by binding bile salts in the gut (interrupting the enterohepatic pathway).

Plant sterols and fiber supplements

Plant sterols (usually sold as sterol esters) are recognized by the FDA as reducing the risk of coronary heart disease, if taken in high enough amounts (2.4 grams of sterol esters per day). There are other useful supplements like artichoke extract, pomegranate, soy protein, Indian gooseberry (Amla), garlic and pantethine (vitamin B5) that are beneficial in terms of prevention of heart attacks and strokes. It would be too lengthy to get into more details here.

5. Take a whey protein supplement

There are two major milk proteins, whey and casein. Only whey protein binds to total and LDL cholesterol, lowering both. It is available in health food stores. Follow the package insert of the whey product for dosing.

6. Increase your omega-3 fatty acid intake

Omega-3 fats are healthy fats naturally present in fish oils and nuts. They increase the amount of circulating HDL cholesterol, which binds the bad LDL cholesterol. Go ahead and eat salmon, herring and mackerel as well as walnuts, ground flaxseeds and almonds. You can also take molecularly distilled (or pharmaceutically pure) EPA/DHA supplements. This pure form of fish oil is free of mercury and other heavy metals. EPA stands for eicosapentaenoic acid or omega-3 fatty acid. DHA is the acronym for docosahexaenoic acid, an important supplement for the brain. Tests have shown that fish oil supplements at a dosage of 3.35 grams per day of EPA plus DHA reduce triglycerides by up to 40%, equally to Lipitor or even more effective, but without the statin side effects. The end result is that your total cholesterol/HDL ratio decreases. This reduces the risk for heart attacks and strokes.

7. Eat foods with anthocyanin

In a 24-week study with diabetic people HDL levels rose by 19% when food was eaten that was rich in anthocyanin. This consisted of eggplant, purple corn, red cabbage, blueberries, blackberries and blackberries. The advantage of raising the HDL cholesterol level is that the total cholesterol to HDL ratio decreases, which lowers the risk for heart attacks and strokes.

8. Exercising regularly

Exercising will increase your HDL cholesterol, which again decreases the ratio of total cholesterol to HDL cholesterol. This number should be between 1 and 3.5, the lower, the better.

9. Take a supplement called Ubiquinol, or Co-Q-10

Adults above the age of 60 need 400 mg once daily, younger people need between 200 mg and 300 mg daily. Co-Q-10 prevents oxidation of LDL cholesterol, which would aggressively attack the arterial walls causing hardening of the arteries. What causes oxidation of cholesterol? The answer is clear: fried foods like french fries or deep fried chicken will lead to oxidation; other culprits are margarine, commercially baked goods and cigarette smoking.

10. Calcium and vitamin D3

11. Polyphenols

Flavonoids are the largest group among the polyphenols in such common foods as vegetables, fruits, tea, coffee, chocolate and wine. Over 130 studies on humans have shown improvement of the lining of the arteries (endothelial functioning) and lowering of blood pressure. Polyphenol consumption has a connection to a lower risk of mortality from heart attacks. Eat a Mediterranean type diet or a DASH diet, and you will automatically get enough polyphenols with your food. However, resveratrol, the powerful red wine polyphenol, warrants a separate daily supplementation as it prevents LDL oxidation in humans (Ref.1). Take about 250 mg of resveratrol daily.

12. Niacin/nicotinic acid

This supplement comes as “flush-free niacin” and also as extended release niacin; it can raise the beneficial HDL cholesterol by 30 to 35% when patients take higher doses of 2.25 grams per day. In a metaanalysis of 7 studies researchers found a significant reduction of heart attacks and transient ischemic attacks (precursor syndrome before developing a stroke). Niacin can change the small particle LDL into a large particle size LDL, which is less dangerous. Niacin also reduces oxidation of LDL, which stops the atherosclerotic process. For a healthy person 500 mg per day of flush-free niacin is adequate.

13. Curcumin

This is a powerful heart and brain protector combining three different mechanisms in one; it is reducing oxidative stress, is an anti-inflammatory and counters the process that threatens to destroy the lining of the arteries. One study on healthy volunteers showed reduction of 33% in lipid oxidation, a 12% reduction of total cholesterol and an increase of 29% of the protective HDL cholesterol when patients took 500 mg of curcumin for only 7 days (Ref.1). This is the daily dose I would recommend for prevention of heart attacks and strokes.

14. Vitamin E (tocopherols)

This fat soluble vitamin is an antioxidant and in the past knew about its use as being heart supportive. Strangely enough some conservative physicians bad-mouthed this vitamin. In the meantime health practitioners have returned to using the vitamin. It turns out that there are 8 different types of tocopherols, with the alpha tocopherol being the best-known, but you also want to be sure that you are getting gamma tocopherol is with your balanced vitamin E supplement every day. It remains the one that is a powerful anti-inflammatory. Simply ask staff at your health food store for a vitamin E supplement with gamma tocopherol in it. Take 400 IU per day (of the mix).

Lower Cholesterol

Conclusion

There is a lot you can do to control your cholesterol level by changing your diet, shedding some pounds, exercising and quitting smoking. All this will contribute to lower cholesterol. This will have a beneficial, long-term effect regarding prevention of heart attacks and strokes. In addition there are specific supplements and vitamins, which prevent heart attacks and strokes as well. With these measures the majority of people with high LDL cholesterol can change their cholesterol levels without taking statins. Statins have serious side effects like Alzheimer’s disease and a painful muscle condition called rhabdomyolysis. None of the other measures described here have any such side effect. Even if you chose to only concentrate on a few of these 14 points to lower cholesterol there will be significant improvements in your LDL and HDL cholesterol levels, when you ask your doctor to order these blood tests.

Some drink milk, others are lactose intolerant; this is the fact about drinking milk.

For a long time the dairy marketing board advertised with the slogan: “Got milk?”. But dairy milk consumption has declined over the past decades.

Why this is has been reviewed in this article. I like to review the problem of lactose intolerance, milk as a source of calcium to prevent osteoporosis and offer alternatives to milk consumption.

Lactose intolerance

Milk cows have been around in Europe for about 6000 years. But not everybody can tolerate milk products. Most of the Europeans, North Americans and Australians have adjusted the digestive enzymes in their duodenum to produce enzymes, called lactase that digest milk sugar (lactose) into glucose and galactose. But up to 75% of the world population (Africa, South America, Asia) is lactase deficient; they cannot tolerate dairy products. They get abdominal cramping, intestinal gas, bloating, diarrhea, nausea and vomiting from drinking a glass of dairy milk. This link explains why goat milk is better than cow’s milk for those who cannot tolerate cow’s milk.

It is also interesting that many people who are lactase deficient can tolerate cheeses, yogurt and other fermented milk products as the fermenting bacteria have digested the lactose.

Other problems with dairy products

Problems with mass production of dairy items are the following:

Concentrated Animal Feeding Operations (CAFO) are responsible for the majority of milk products on grocery market shelves. This means that the animals are fed unnatural corn, which leads to deficiencies and omega-6 fatty acids in the milk products.

Antibiotics are given to prevent infections among the herds of animals.

Bovine growth hormone (bST, bovine somatotropin) is administered to stimulate more milk production. The antibiotics lead to superbugs in humans, the bST may be causing autoimmune diseases and breast cancer in humans. The healthiest milk is milk from grass-fed cows. It is high in omega-3 fatty acids. All of the milk products derived from this type of milk are also healthy.

Milk as a source of calcium

One key advertising slogan of the dairy industry used to be that milk would be such a good source of calcium, which would prevent osteoporosis. But milk also has a lot of animal protein in it, which acidifies blood. This means that the kidneys use calcium to neutralize acidic blood and excrete calcium. The net result is that there is more calcium leaving the body as some of the calcium from the bone is also used to keep the balance between acidity and alkalinity.

This 12 year long Harvard Nurses’ Health Study involving 77, 761 women between the ages of 34 to 59 showed that a higher consumption of milk did not protect against hip and wrist fractures.

The myth that full fat milk causes heart attacks and strokes

There is another myth floating around, namely that full fat milk would be bad for the heart because of increased saturated fatty acids. But an Australian study showed that full fat milk is healthier for you than milk with less fat.

After 14.4 years of follow-up the group that consumed the most milk compared to the lowest fat intake group had a 69% lower death rate from cardiovascular disease!

A 2016 study showed that consumption of plain yogurt was associated with better health outcomes on the long term. Be more concerned about the sugar content than the fat content of yogurt!

Prevention of osteoporosis

Too many years have been wasted to sell the false concept of increasing milk consumption (“Got milk?”) for increased calcium intake and possible osteoporosis prevention. It was sold like a mantra: Milk-calcium-osteoporosis prevention. Now we know the real truth behind the false advertising mantra: milk provides protein and calcium, but calcium is poorly absorbed and the acidified blood is alkalinized through calcium from milk and from the bone being excreted into the urine. The end result is a net loss of calcium from the bone, as it is more important to the body to keep the blood’s acid/base stable than to increase the calcium level in the bone. Sadly all the high consumers of milk from the Harvard Nurses’ Health Study ended up having fractures from osteoporotic bones.

Prevention of osteoporosis requires intake of vitamin D3, vitamin K2 and calcium (supplement or diet) as I have reviewed in this blog. In addition regular exercise is also very beneficial as is bioidentical sex-hormone replacement. It is interesting that a large clinical trial that I mentioned in this blog showed after 7 years that there were 35% to 38% less fractures of the hip than in the placebo group. Vitamin K2 is essential to keep calcium in the bones and to keep calcium out of the blood vessel walls. Vitamin D3 is important for calcium absorption through the gut wall and to deposit calcium into bone. Without all of these ingredients it is not possible to prevent osteoporosis.

Alternatives to milk consumption

One obvious step is to replace cow’s milk by goat milk. As you can see from this link, there are many advantages to goat milk. What I find important is the fact that those with lactase deficiency often can tolerate goat milk while they would otherwise react to cow’s milk. There are also many goat milk products like cheese and yogurt, all of which are very healthy. They do not contain any antibiotics or bovine growth hormone (bST), which is only used in cows. Goat milk products are also an excellent source of protein.

You can eat a more vegetable-based diet. A lot of vegetables and fruit have calcium and protein in them.

You can consume almond milk instead of cow’s milk. The downside to know is the fact that almond milk is not a significant source of protein. It has the advantage of being slightly alkaline; this will ensure that the calcium absorbed in the gut will reach the bones as long as you also supplement with vitamin D3 and vitamin K2. The many “fake milk” products such as rice milk, coconut milk and hemp milk are also poor protein sources. The only product higher in protein is soymilk. But soy has its own problems: over 90 % of the crop in North America is genetically engineered, and soy is a known allergen. As of recent, another product based on pea protein is available, and the protein content is excellent, so it is worth looking for it (It is called “Ripple”).

Some Drink Milk, Others Are Lactose Intolerant

Conclusion

Drinking milk as a source of protein and calcium has become an obsession a few decades back. In the meantime it turned out that drinking milk tips the acid-base balance in the direction of acidity. This causes osteoporosis, as the kidneys excrete all of the calcium from milk that is absorbed. On top of that even more calcium is taken out from bones to recalibrate the acid-base balance.

Up to 75% of the world population is lactose intolerant. They get sick from drinking cow’s milk. But they usually tolerate goat milk quite well. Considering the fact that antibiotics are used in cow milk production and recombinant bovine growth hormone as well, I have joined the crowd that prefers goat milk instead of cow’s milk. I take the supplements I mentioned for bone maintenance (vitamin D3 and K2) and I get lots of calcium also from vegetables and salads. I have no lactose intolerance, but that’s my take on milk.

Conventional medicine has ignored for several decades that lower blood sugar prevents diabetes. After this topic has been reevaluated, it has become clear what should be normal blood sugar values. Another evaluation concentrates around the hemoglobin A1C range.

What is worse is the fact that patients with prediabetes get complications that are normally associated with diabetes. These include kidney disease, retinal problems with loss of vision, neuropathy, hardening of the arteries and cancer.

Key to preventing this from happening is to recognize that prediabetes is already the beginning of diabetes. Not only should diabetes be prevented, but prediabetes as well.

Determination of prediabetes and diabetes

Prediabetes

Fasting blood sugar between 100 and 125 mg/dL (5.6 to 6.9 mmol/L) was considered to be prediabetes.

Diabetes

126 mg/dL (7 mmol/L) or higher on two separate tests indicates that you have diabetes.

Glycated hemoglobin (A1C) test

This test gives an average of blood sugar over 2 to 3 months. A hemoglobin A1C test below 5.7% was considered normal, between 5.7 and 6.4 percent indicated prediabetes and at 6.5 or higher on two separate tests meant you have diabetes.

Re-evaluating normal ranges to diagnose diabetes and prediabetes

Many researchers have said that the normal values from the guidelines for blood sugar or for glycated hemoglobin A1C are too high. This is the reason why diabetic complications developed even with prediabetes.

At the 22nd Annual World Congress on Anti-Aging Medicine In Las Vegas (Dec. 10-14, 2014) Dr. Piliszek stated that the normal range for hemoglobin A1C is skewed in the medical literature. It should be: 3.8% to 4.9%. This is very important to know for diabetics and any caregiver who looks after diabetes patients. If you are satisfied with a hemoglobin A1C of 6.0 as still being “normal”, the diabetic patient has the risk of dying prematurely of a heart attack or a stroke. According to the new guidelines even a patient whose hemoglobin A1C is 5.5 has diabetes with the new guidelines and needs to be treated aggressively to prevent complications associated with diabetes. Conventional guidelines would have considered this patient to be normal.

A 1999 study made it clear that patients with a blood sugar of more than 85 mg/dL were at risk of developing diabetes complications. About 2000 patients with fasting blood sugars of more than 85 mg/dL were observed over 22 years. About 40% of them died of heart attacks or strokes!

The authors concluded that fasting blood glucose in the upper normal range was an independent risk factor of cardiovascular death.

New guidelines

Prediabetes is not a separate diagnosis, but is mild early diabetes, which is reversible with aggressive treatment. Dietary changes (cutting out sugar and refined carbs) are often effective. In some cases the addition of metformin may be required.

The new normal ranges are:

Fasting blood sugar of 85 mg/dL or less is normal.

Hemoglobin A1C of 3.8% to 4.9% is the new normal range.

These values are based on observing patients over a long period of time and seeing whether or not they develop complications from diabetes.

Uncontrolled diabetes leads to complications like damage to the lining of the arteries in all the key organs. It is the cause for the following conditions: kidney damage (nephropathy), eye damage (retinopathy), brain and nerve damage (neuropathy), as well as heart attacks and strokes (vascular damage).

Patients often end up with dialysis when kidney failure has set in. Retinopathy causes blindness and neuropathy leads to excruciating pain. Heart attacks and strokes often cause premature death. Those who ingest a high-glycemic diet have a 49% higher risk of getting lung cancer than those with a low-glycemic diet as this link from the MD Anderson Cancer Center showed.

Calorie restriction

A research group found that calorie restriction reduced fasting insulin levels in a group of overweight men and women.

Some practical hints about diets to treat diabetes

The obvious fact is that excessive sugar intake is harmful. But in addition a drastic reduction of refined carbs is also needed, as they just turn into sugar within half an hour of ingesting them. Cut out potatoes, pasta, and bread. You may have a slice of rye bread or full grain bread occasionally. This type of diet is called a low-glycemic index diet. As indicated earlier a study from the MD Anderson Cancer Center has shown that lung cancer is more common the higher the glycemic index is and is also more common in diabetics.

A Mediterranean diet has been shown to be anti-inflammatory. As diabetes and prediabetes are associated with chronic inflammation, it is useful to go on a diet that counters inflammation. The DASH diet, which was developed for high blood pressure patients, is also anti-inflammatory. Here are a few examples of snacks that may be helpful.

Include fish and fish oil supplements in your diet. These contain omega-3 fatty acids, which are anti-inflammatory. Eat lots of vegetables and salads as they contain healthy bioflavonoids and antioxidant vitamins. This stabilizes the lining of your arteries.

Lower Blood Sugar Prevents Diabetes

Conclusion

The old blood sugar and hemoglobin A1C guidelines are outdated. Instead new guidelines based on actual measurements and clinical trials that showed no complications of prediabetes on the long term have replaced them.

A fasting blood sugar of 85 mg/dL or less is normal. A hemoglobin A1C of 3.8% to 4.9% is now the new normal range.

The doctor needs to be more aggressive about early nutritional intervention and possibly include metformin as well to restore insulin sensitivity. It is no longer appropriate to allow complications of diabetes like nephropathy, retinopathy or neuropathy to develop. Unfortunately food manufacturers still overload processed food with sugar. Each patient needs to be vigilant about the food he/she eats. Low glycemic nutrition is the mantra to follow. Also stick to natural, unprocessed foods instead of the highly processed foods that populate the shelves of the supermarkets.

Dr. Mark Rosenberg gave a talk on prevention of telomere shortening. This was presented at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The detailed title was: “The Clinical Value of Telomere Testing”.

What are telomeres?

Telomeres are the caps at the end of chromosomes. They are very important in the aging process. Prematurely shortened telomeres are linked closely to all major diseases like cardiovascular disease, cancer, diabetes and more. Telomeres are also a measure of the aging process. Aging occurs due to a decrease of the number of cells in organs and/or because of a lack of functioning of these organs. Telomeres get shortened every time a cell divides. But when the telomeres are used up, there comes a time when cells can no longer divide. These cells become senescent cells or they enter apoptosis (programmed cell death).

The senescent cells can become a problem when they get transformed into cancer cells and their telomeres lengthen again. These cancer cells divide rapidly and this can become the reason why cancer patients to die.

What is the significance of telomeres?

Telomere dysfunction is the first sign that the telomeres are getting shorter in a person compared to the average telomere length in a comparable age group. This is not only important for aging, but also has clinical implications. The shorter telomeres are, the higher the risk for cardiovascular disease. Telomere length also provides prognostic information about the mortality risk (risk of dying) with type 2 diabetes and for many cancers. Many physicians incorporate a telomere blood test into periodic health checks, if the patient can afford it.

Interventions that help telomere length

Here are a number of things we can do to lengthen our telomeres.

Rosenberg mentioned that the strongest effect on telomere lengthening comes from caloric restriction and weight loss. 80 years ago they showed at the Cornell University that rats put on calorie restriction had a 30% increase in their mean and maximum lifespan. Many research papers have confirmed that the same is true in man and that the common denominator is telomere lengthening.

Next are regular physical activity, meditation, reduction of alcohol consumption and stopping to smoke.

Telomerase activators. Here is some background on the TA-65 telomerase activator, which is based on Chinese medicine. A one year trial was completed with 250 units and 1000 units of TA-65 per day. The lower dose (250 units) showed effective telomere lengthening, while the placebo dose did not. The 1000 unit dose did not show statistical significance.

Should you wish to take TA-65, only take 250 units per day, not more.

Cancer and telomeres

There is a strong correlation between cancer and telomere shortening. When cells are at the brink of dying toward the end of their life cycle the telomeres get shorter and shorter. This is the point where the cells can turn malignant. Certain genetic abnormalities help the malignant transformation, like 11q or 17q deletions or a p53-dependent apoptosis response. Once cancer cells have established themselves they activate telomerase in 85% of cases. In the remaining 15% of cancer cases telomeres are activated through telomerase-independent mechanisms. Here are a few examples.

CLL

CLL stands for chronic lymphocytic leukemia. It is a disease of the aging population. At age 90 people’s bone marrow cells have a telomere length of only 50% of the length at birth. This is the reason that in older age CLL is more common. Researchers observed a population segment and found that the shorter telomeres were, the poorer the overall prognosis and overall survival for CLL was.

Lung cancer

In patients with non-small cell lung cancer the telomerase activity was examined. When telomerase activity was present, the 5-year survival was only 55%. When telomerase activity was absent, the prognosis was 90% survival after 5 years.

Prostate cancer

Telomere shortening in stromal cells was found to be associated with prostate cancer risk. Men with shorter telomere length in stromal cells had a 266% higher risk of death compared to men with normal telomere length.

Another study took blood samples and determined the telomere length in lymphocytes (the immune cells). Those men who came down with prostate cancer within a year after the blood sample was taken had short telomeres. The risk for prostate cancer in these patients was 355% higher than in the prostate cancer negative controls.

Yet another study looked at surgical tissue samples from 596 men that

Underwent surgery for clinically localized prostate cancer. Patients whose samples showed variable telomere lengths in prostate cancer cells and shorter telomeres compared to prostate samples with less variable telomere length and longer telomeres had a much poorer prognosis. They had 8-times the risk to progress to lethal prostate cancer. And they had 14-times the risk of dying from their prostate cancer.

Breast cancer

Breast cancer is diverse and consists of cases that are genetically inherited (BRCA1 and BRCA2), but there are also cases where the cancer is local or more advanced (staging). In families with mutated BRCA1 and BRCA2 telomeres are significantly shorter than in spontaneous breast cancer. Increased telomerase activity in breast cancer cases is directly related to how invasive and aggressive the breast cancer is.

One study was shown where blood leukocytes were analyzed for telomere length in 52 patients with breast cancer versus 47 control patients. Average telomere length was significantly shorter in patients with a more advanced stage of breast cancer than in early breast cancer. Mutated HER patients had the shortest telomeres. It follows from this that checking for the HER status and blood telomere testing adds to the knowledge of potential cancer development and prognosis.

Short telomere length was associated with larger breast tumors, more lymph node metastases and more vascular invasion. More aggressive breast cancer cells have higher telomerase activity. More than 90% of triple negative breast cancers have short telomeres.

CNS disorders and telomeres

Dr. Rosenberg presented evidence that shorter telomeres are associated with dementia. But dementias with Lewy bodies and Alzheimer’s disease are also linked to short leukocyte telomeres. The length of blood telomeres predicts how well stroke patients will do and how people with depression will respond to antidepressants.

Cardiovascular disease and telomeres

Our blood pressure is kept constant through the renin-angiotensin-aldosterone system. When this system is not stable, our blood pressure shoots up and causes cardiovascular disease. This is tough for the heart, as it has to pump harder against a higher-pressure gradient. A study of 1203 individuals was examining the connection between leukocyte telomere length and renin, aldosterone and angiotensin II activity. It concluded that oxidative stress and inflammatory responses affect the telomere length of leukocytes and that the more stress there is in the renin-angiotensin-aldosterone system, the more cardiovascular disease develops. The conclusion of the study was that the overall cardiovascular stress leads to shortening of leukocyte telomeres.

Prevention Of Telomere Shortening

Conclusion

Telomere length testing from a simple blood test will become a more important test in the future as hopefully the cost comes down (currently about 300$). It can predict the general aging status by comparing a single case to the general telomere length of the public. But it can also predict the cancer risk, risk for mental disease and cognitive deficits (Alzheimer’s disease). In addition your cardiovascular status is also globally assessed with this test. What can be done, if the test comes back with short telomeres?

It allows you to change your lifestyle and adopt a healthy diet. You can exercise regularly, take antioxidants and meditate. There are even telomerase activators that are gradually becoming more known. They lengthen the telomeres. The cost of telomerase activators will likely still be a problem for some time. All in all telomere length tests are here to stay, but effective intervention at this point is largely limited to healthy lifestyle choices. This is good news: healthy lifestyle choices like non-smoking, exercise and avoiding non-processed foods are either free or have a reasonable price tag. Telomerase activators are big business and at this point not really affordable!

Dr. Pamela W. Smith gave a talk about new treatments for premenstrual syndrome (PMS). She presented this talk on Dec. 11 at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The original title was “New Treatment Modalities for PMS”.

Signs and symptoms of PMS

Dr. Smith discussed signs and symptoms of PMS first. She showed 9 slides where she listed all of the symptoms of PMS that commonly occur.

What do we know about PMS?

There is no definitive test that would help in the diagnosis of PMS. But we do know that there is a hormone dysfunction that leads to a monthly recurrence of symptoms during the two weeks prior to the woman’s menstruation. When her period begins or shortly after all of these symptoms disappear.

PMS is very common; 70to 90% of women have a certain degree of PMS. In 20 to 40% of women symptoms are severe. Many researchers have shown that there is a problem in the feedback loop between the pituitary gland and the ovaries. This leads to a decrease of progesterone production in the ovaries. The result is an overabundance of estrogen, which is called estrogen dominance.

But things can get complicated when other hormone changes occur. A woman may also turn hypothyroid. When she gets closer to menopause estrogen deficiency may also develop. Electrolyte disturbances can occur from high estrogen levels causing excessive aldosterone levels. This would lead to high sodium and low potassium blood levels. The end result may be an activation of the renin-angiotensin system, which could cause high blood pressure.

Neurotransmitters are often disbalanced. When serotonin is low in the brain, depression can develop. Noradrenalin deficiency leads to a lack of focus, energy and memory.

Hypoglycemia is also common among women with PMS. This may be due to cravings for sweets and consumption of starchy foods. Women who crave sweets may also consume caffeine excessively. But caffeine increases prostaglandin production in the body. This leads to breast tenderness, abdominal cramping, arthritis and back pains.

A partial hysterectomy can cause PMS in a woman who never before had symptoms of PMS. The current school of thought is that blood supply to the ovaries after a hysterectomy has decreased, and this could be the reason for the onset of PMS.

The birth control pill can bring on PMS due to the progestin component in it.

Tubal ligations can also be a cause: 37% of women who had tubal ligations develop PMS. The reason is a change in hormone production. In these women estrogen is produced to a higher degree than progesterone is.

Pregnancies, miscarriages and abortions can also bring on PMS.

Lab tests for women with PMS

Although there is no single test that would be able to diagnoses PMS, a variety of abnormal tests are often abnormal in association with PMS. Frequently there is deficiency for vitamin A, B6, E, magnesium, potassium, zinc and trace minerals. Calcium can be too high or too low, but blood tests will reveal that.

Four PMS types

PMS A is associated with estrogen excess and progesterone deficiency. There is a diminished stress response in the hypothalamus/pituitary/adrenals axis. Symptoms are mainly anxiety, irritability, insomnia and emotional lability.

PMS H is caused by increased aldosterone activity triggered by estrogen surplus in the late luteal phase. Symptoms are weight gain, swelling of hands and feet, a feeling of bloating, breast tenderness or engorged breasts. Women will find that their clothes simply fit tighter.

Migraine headaches in PMS

Some women with PMS are plagued by migraine headaches. It may have started in puberty or after taking birth control pills for contraception. Sometimes the onset is after a pregnancy, miscarriage or abortion. When PMS develops and a woman has migraines, they usually occur around the same time in her menstrual cycle. With pregnancy the migraines disappear in the last trimester when progesterone hormone production from the placenta is the highest.

Hormonally related headaches can occur for 4 main reasons.

When estrogen and progesterone are on the rise around the time of ovulation

When a woman has hypoglycemia (due to hyperinsulinemia)

When estrogen levels are changing

When there is estrogen dominance

Treatment for PMS

Dr. Smith explained in detail the various treatment modalities for PMS. Treatment has to be personalized according to what type of PMS the doctor thinks that the patient is suffering of.

Dietary factors

In the beginning it is important to pay attention to the diet. Studies have shown that PMS patients tend to eat too many carbs and too much refined sugar compared to patients without PMS. PMS patients also eat too many dairy products and too much sodium. In addition PMS patients are deficient in iron, manganese and zinc. A good start is a Mediterranean diet, which is at the same time anti-inflammatory.

The recommendations is to eat 6 small meals a day. Avoid caffeine and alcohol. They are antagonists to the B complex vitamins. By avoiding sugar, you also avoid fluid accumulation and magnesium deficiency. A low fat, high-complex carb diet helps reduce breast tenderness. Reducing fat and increasing fiber in the diet decreases estrogen levels in the blood. These steps help PMS symptoms.

Nutritional supplements

Magnesium, vitamin B6, A, D3, E, L-tryptophan, calcium, zinc, fish oil (EPA/DHA) and evening primrose oil are the main supplements recommended for PMS patients. Your healthcare provider can advise you what you should take and what dosage.

Exercise

Regular exercise has very beneficial effects on reducing many symptoms of PMS. Even as little as 8 weeks of exercise -as was done in this study- had a significant effect. Exercise elevates endorphin levels, improves blood sugar stability, decreases norepinephrine and epinephrine in the brain and helps to decrease estrogen levels. This will control blood sugar levels, reduce anxiety, reduce estrogen-related symptoms and increase satisfaction.

Thyroid medication

Many women with PMS have borderline hypothyroidism or are overtly hypothyroid. In these cases the patient should receive small amounts of thyroid hormones.

Progesterone

Progesterone is the one hormone that is found persistently lacking in most PMS patients. The best test for this is a saliva hormone test, because this reflects the tissue levels. Blood levels test too low and are useless. Bioidentical progesterone cream is applied transdermally (through the skin) from day 14 to 25 of each menstrual cycle. Micronized progesterone pills are also bioidentical and could be used instead of the cream.

Botanicals

There are a number of home remedies, which are heavily promoted on the Internet. They may, however, not be as effective as advertised.

Black Cohosh is said to balance estrogen and is anti-spasmodic.

Chasteberry decreases LH and prolactin. It raises progesterone, acts as a diuretic and binds opiate receptors. This reduces PMS related aches and pains.

St. John’s Wort helps these symptoms: anxiety, depression, mood swings, feeling out of control and pain.

Ginkgo biloba is a mild blood thinner. Women who are on blood thinners should not use it! It improves depressive symptoms and mood, has anti-inflammatory effects and helps with anxiety control.

Saffron: In a clinical trial the Saffron group did significantly better in PMS symptom control than the placebo group. Saffron is rich in magnesium, vitamin B6, iron and other nutrients that are missing in PMS patients, which explains the effectiveness of this botanical.

Other botanicals: Other botanicals are Lavender, Motherwort, and Dandelion.

Candidiasis

Due to prolonged exposure to high sugar and refined carb intake many women with PMS suffer from candidiasis (chronic yeast infection). Anti-Candida programs help to eradicate Candida overgrowth, which often improves several PMS symptoms.

Mind/body therapy

Cognitive-behavioral therapy helps for depression and anxiety. Hypnotherapy, yoga and biofeedback therapy are also useful methods.

New Treatments For Premenstrual Syndrome

Conclusion

At the present time there is a better understanding of PMS than in the past. Progesterone deficiency and other hormone weaknesses seem to be at the center of this condition. But vitamin and mineral deficiencies also play a role. The healthcare provider should order some baseline blood tests and hormone tests for the patient, including a saliva progesterone level.

Treatment consists of a combination of steps taken simultaneously. The dietary approach comes first: a Mediterranean diet will be beneficial. Next add nutritional supplements. Regular exercise is essential. Finally bio-identical hormone replacement of the missing hormones is necessary.

If there is an underlying chronic candidiasis infection, it needs treatment. The choice of drug would be nystatin. Some botanicals may be helpful, as discussed. When anxiety and depression are important parts of the PMS symptoms, mind/body therapy (such as cognitive therapy etc.) may also be helpful.

The key with PMS treatment is to not give up, but to re-evaluate the condition, if the initial attempt does not bring full relief. By not giving up and using all modalities of treatment the patient will be able to get rid of the condition, eliminate the symptoms of PMS and achieve well being.

Dr. Ray Schilling

Dr. Ray Schilling born in Tübingen, Germany and Graduated from Eberhard-Karls-University Medical School, Tuebingen in 1971. Once Post-doctoral cancer research position holder at the Ontario Cancer Institute in Toronto, is now a member of the American Academy of Anti-Aging Medicine (A4M). [About Dr. Ray Schilling …]